Self-Management Education for Bipolar Disorders: A Hermeneutic-Phenomenological Study on the Tacit Knowledge of Mental Health Nurses

Abstract

Background: Self-management of bipolar disorder (BD) education is a complex nursing intervention in which patients and informal caregivers are taught to be actively involved in self-monitoring and self-regulating activities. Some studies question if nurses are sufficiently equipped to deliver these educational tasks. Other studies suggest that nurses have gathered their knowledge implicitly by experience, but to date, this tacit knowledge is not described from the experiences of mental health nurses (MHNs) in ambulant BD care.

Objective: To detect the tacit knowledge used by MHNs by interpreting their experiences in delivering self-management education to people with BD and their informal caregivers.

Methods: A phenomenological-hermeneutical study amongst MHNs (N = 9) from three ambulant BD care clinics in the Netherlands. Face-to-face, open, in-depth interviews guided by a topic list, were conducted and transcribed verbatim prior to the hermeneutical analysis.

Findings: We found five categories resembling the complex character of self-management interventions provided by MHNs: Building a trustful collaboration, Starting a dialogue about needs and responsibilities, Explaining BD, Utilizing mood monitoring instruments, and Conceptualizing self-management of BD.

Conclusion: Eventually MHNs use tacit knowledge to cope with situations that demand an outside-the-box approach. Self-management education is partially trained and partially mastered through experience.

Practice implications: In order to facilitate long-term self-management of BD, the collaboration of a supporting network is essential.

Acknowledgment

We would like to thank Ciska Wilms of 4OfficeAssistance for transcribing the interviews verbatim.

Disclosure statement

None of the authors have competing interests.

Ethical approval

Ethical review of the full study was conducted by the Radboud University Central Ethical Committee. The Regional Ethical committees of Dimence, Mediant, and Rivierduinen granted access and approval for data collection.

Additional information

Funding

This study was funded through an educational grant from the Dutch Ministry of Education, Culture and Science.

Notes on contributors

S. C. G. H. van den Heuvel

Silvio van den Heuvel (SvdH): designed the study, collected, analyzed and interpreted data, and drafted the manuscript. Peter Goossens (PG): co-designed the study, peer-debriefing of analyzed and interpreted data, and drafted the manuscript. Cees Terlouw (CT): co-designed the study, peer-debriefing of analyzed and interpreted data, and drafted the manuscript. Lisette Schoonhoven (LS): co-designed the study and supervised peer debriefing. Theo van Achterberg (TvA): co-designed the study and revised the article critically for important intellectual content.

P. J. J. Goossens

Silvio van den Heuvel (SvdH): designed the study, collected, analyzed and interpreted data, and drafted the manuscript. Peter Goossens (PG): co-designed the study, peer-debriefing of analyzed and interpreted data, and drafted the manuscript. Cees Terlouw (CT): co-designed the study, peer-debriefing of analyzed and interpreted data, and drafted the manuscript. Lisette Schoonhoven (LS): co-designed the study and supervised peer debriefing. Theo van Achterberg (TvA): co-designed the study and revised the article critically for important intellectual content.

C. Terlouw

Silvio van den Heuvel (SvdH): designed the study, collected, analyzed and interpreted data, and drafted the manuscript. Peter Goossens (PG): co-designed the study, peer-debriefing of analyzed and interpreted data, and drafted the manuscript. Cees Terlouw (CT): co-designed the study, peer-debriefing of analyzed and interpreted data, and drafted the manuscript. Lisette Schoonhoven (LS): co-designed the study and supervised peer debriefing. Theo van Achterberg (TvA): co-designed the study and revised the article critically for important intellectual content.

L. Schoonhoven

Silvio van den Heuvel (SvdH): designed the study, collected, analyzed and interpreted data, and drafted the manuscript. Peter Goossens (PG): co-designed the study, peer-debriefing of analyzed and interpreted data, and drafted the manuscript. Cees Terlouw (CT): co-designed the study, peer-debriefing of analyzed and interpreted data, and drafted the manuscript. Lisette Schoonhoven (LS): co-designed the study and supervised peer debriefing. Theo van Achterberg (TvA): co-designed the study and revised the article critically for important intellectual content.

T. van Achterberg

Silvio van den Heuvel (SvdH): designed the study, collected, analyzed and interpreted data, and drafted the manuscript. Peter Goossens (PG): co-designed the study, peer-debriefing of analyzed and interpreted data, and drafted the manuscript. Cees Terlouw (CT): co-designed the study, peer-debriefing of analyzed and interpreted data, and drafted the manuscript. Lisette Schoonhoven (LS): co-designed the study and supervised peer debriefing. Theo van Achterberg (TvA): co-designed the study and revised the article critically for important intellectual content.